Incident Report in Hospital

---

I. Incident Details:

• Date of Incident: May 15, 2050

• Time of Incident: 10:30 AM

• Location: Ward 3B

• Reported By: [YOUR NAME]

• Position: Registered Nurse

II. Description of Incident:

[PATIENT'S NAME], a patient admitted to Ward 3B for post-operative care following a hip replacement surgery, attempted to get out of bed unassisted despite explicit instructions to call for assistance. The patient lost his balance and fell to the floor, resulting in a minor head injury. The fall occurred while [YOUR NAME] was attending to another patient in the ward.

III. Witnesses:

1. Nurse Robert Jordon

   • Email: robert@email.com

   • Phone: 801-774-6761

2. Nurse Mikhail Brannon

   • Email: mikhail@email.com

   • Phone: 801-205-6234

IV. Patient Information:

• Patient Name: [PATIENT'S NAME]

• Patient ID: 82049402BY

• Patient Room Number: 3B

V. Staff Involved:

1. [YOUR NAME]

   • Position: Registered Nurse

2. Nurse Robert Jordon

   • Position: Registered Nurse

VI. Actions Taken:

• The patient was promptly assisted back to bed and assessed for injuries.

• Vital signs were monitored, and a thorough neurological assessment was conducted.

• A cold compress was applied to the minor head injury.

• The attending physician, Dr. Scott Grant, was immediately notified of the incident for further evaluation and documentation.

VII. Follow-up Actions:

• The incident was promptly reported to the hospital administration and risk management team.

• A root cause analysis (RCA) will be conducted to determine contributing factors and preventive measures.

• The incident will be discussed in the upcoming safety committee meeting to implement necessary changes in fall prevention protocols.

• Nurse [YOUR NAME] and Nurse Robert Jordon will undergo additional training on fall prevention strategies and patient safety protocols.

VIII. Recommendations:

• Consider implementing bed alarms for high-risk patients to alert staff of attempts to leave the bed unassisted.

• Conduct regular rounds to assess patients' mobility status and reinforce patient education on the importance of calling for assistance when needed.

• Review and update fall prevention policies and procedures to ensure compliance with best practices.

IX. Additional Comments:

[PATIENT'S NAME] remained stable following the incident and expressed understanding regarding the importance of following instructions for safety. He has been closely monitored for any signs of complications, and his care plan has been adjusted accordingly to prevent future incidents.

Report Templates @ Template.net